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J Thorac Cardiovasc Surg 2007;134:1375-1376
© 2007 The American Association for Thoracic Surgery

Brief Communication

Management of a traumatic aortoesophageal fistula in a patient with a right-sided aortic arch

Daniel Vallböhmer, MD, Arnulf H. Hölscher, MD, PhD, Jan Brunkwall, MD, PhD, Michael Gawenda, MD, PhD*

Department of Visceral and Vascular Surgery, University of Cologne, Cologne, Germany.

Received for publication June 26, 2007; accepted for publication July 19, 2007.

* Address for reprints: Michael Gawenda, MD, PhD, Department of Visceral and Vascular Surgery, Division of Vascular Surgery, University of Cologne, Kerpenerstraße 62, 50937 Cologne. (Email: michael.gawenda@uk-koeln.de).

The first 20% of the full text of this article appears below.

Aortoesophageal fistulas are critical conditions with a high rate of morbidity and mortality. We present the management of a patient with a right-sided aortic arch in whom a traumatic aortoesophageal fistula developed after a car accident.

Clinical Summary

A 23-year-old woman was involved in a high-speed car accident and transferred to an outside hospital. Injuries at admission included fractures of the left pelvic ring, right humerus, multiple ribs, and lumbar vertebra. In addition, lung contusions and various skin lesions were present. Acute surgical therapy consisted of the stabilization of the pelvic fracture by external fixation and an intramedullary nailing of the humeral fracture.

Three weeks after an uneventful postoperative course, an acute hematemesis developed in the patient. Upper endoscopy failed to detect the localization of the gastrointestinal bleeding because of the persistence of the severe hematemesis. A laparotomy with gastrostomy was performed, revealing massive esophageal bleeding. A Linton–Nachlas balloon tube . . . [Full Text of this Article]




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[Abstract] [PDF]


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